Variation in dietary intake and body fatness by socioeconomic status among women in the context of Costa Rican nutrition transitions

Diet-Attributable Greenhouse Gas Emissions and Acute Myocardial Infarction in Costa Rica Heart Study

Adopting sustainable dietary patterns is essential for planetary and human health. As data to address this issue are lacking in Latino populations, this study examined the association between diet-attributable greenhouse gas emissions (GHGEs) and myocardial infarction (MI) in a Costa Rica Heart Study. This analysis included 1817 cases of a first non-fatal acute MI during hospitalization and their matched population-based controls, by age, sex, and area of residence. A validated food frequency questionnaire was used to quantify habitual dietary intake and diet-attributable GHGEs (kg CO2 equivalent (eq.)/year). Due to the matching design, conditional logistic regression was used. Red meat consumption contributed approximately 50% to the total diet-attributable GHGEs among both cases and controls. Higher diet-attributable GHGEs were associated with increased odds of acute MI. The odds of MI were 63% higher (OR = 1.63; 95% CI 1.20-2.21) among participants in the highest quintile (median diet-attributable GHGEs = 6247 kg CO2 eq./year) compared to the lowest quintile (median diet-attributable GHGEs = 2065 kg CO2 eq./year). An increasing linear trend in the odds of acute MI and diet-attributable GHGEs was detected (p-trend 0.0012). These findings highlight the importance of reducing red meat consumption to sustainably mitigate the incidence of MI and improve planetary health.

Nutritional status and body image perception in a group of moroccan adolescents

BACKGROUND: Adolescent obesity has become a pressing public health issue in Morocco. Along with the increased prevalence of obesity, body weight misperceptions have also increased among adolescents, which may reduce the effectiveness of intervention programs. The main study objective was to establish the relationship between body image perception, anthropometric status and their associated factors among a sample of Moroccan adolescents. METHODS: A cross-sectional school-based survey was conducted during 2018, involving 250 adolescents from Morocco. Data on sociodemographic information, anthropometric characteristics, and weight perception were collected and reported as the means and proportions. Statistical analysis was carried out using Statistical Package for Social Sciences version 19.0 software. RESULTS: The prevalence of overweight and obesity in our study reached 12.8% and 4.8%, respectively. Misperception of body weight compared to body mass index (BMI) was found in 50.4% of young adolescents (χ2 = 54.05; p <  0.001), and dissatisfaction computed by the Feel minus Ideal Discrepancy (FID) index reached 46% with no difference between the sexes (χ2 = 2.55; p >  0.05). The Feel weight status minus Actual weight status Inconsistency (FAI) index was used to determine whether the subjects’ perception of their weight was realistic. The results showed that both sexes tended to underestimate their weight. Only 68.2% of overweight/obese participants reported trying to lose weight (χ2 = 39.74; p <  0.001), while this number increased to 94.7% when the intention to lose weight was related to perceived body image (χ2 = 86.09; p <  0.001). CONCLUSIONS: The results of this study reveal that a mismatch exists between the perception of body weight and actual BMI in adolescents, with a tendency toward underestimation, affirming the early effect of social norms and the vulnerability to sociocultural influences of individuals in this age category. Future interventions and educational programs are thus required to prevent overweight and obesity and to address the mismatch between adolescents’ weight status and their perceived weight.

[Intake of processed meats by Costa Rican women: effect of socioeconomic status]

Introduction

Intake of processed meats has been associated with serious health problems that are common among women. In 2015, the International Agency for Research on Cancer classified processed meats as human carcinogens, associated specifically with colon cancer. The increase in intake of processed meats, which are a low-cost source of dietary protein, varies by socioeconomic status (SES) and can impact chronic disease incidence.

Objective

Examine the association between processed meats intake and (a) total protein intake, (b) inadequate protein intake, by SES.

Methods

This study included a representative sample (N = 135) of women age 25 to 45 years, with one to four children, from three different socioeconomic groups who were residents of two counties from the Greater Metropolitan Area of San José, Costa Rica between June 2014 and March 2015. Using photographs, we examined women's perceptions of the cost and perceived desirability of 12 different foods, including processed meats. Using 24-hour dietary recalls collected on three different days, and the ValorNut food composition database, we estimated total protein intake, in grams, and determined the intake frequency (times/day) of processed meat. Each women's dietary protein requirement was estimated based on her bodyweight. Inadequate protein intake was calculated as the difference between protein requirement and actual intake. A linear regression model was used to determine the association between total protein intake in grams and intake frequency (times/day) of processed meat. A logistic regression model was used to estimate the association between low protein intake and intake frequency (times/day) of processed meat.

Results

Processed meats were perceived as the least preferred protein source but were the third most commonly consumed protein source. Consumption of processed meats differed by SES and was lower in the higher SES group (P < 0.01). The most commonly consumed processed meats by SES were "mortadella" (low-SES), sausages (middle-SES), and sliced turkey/ham (high-SES). Processed meat intake was significantly associated with an increase in protein intake. There was an inverse association between SES and inadequate protein intake.

Conclusions

Processed meat intake is associated with SES. Women may consume processed meats because they are perceived to be a low-cost protein source. Educational strategies are needed to help women identify their protein needs and meet those needs with healthier and affordable dietary alternatives.

A Traditional Costa Rican Adolescents' Diet Score Is a Valid Tool to Capture Diet Quality and Identify Sociodemographic Groups With Suboptimal Diet

Traditional diet indices may capture diet quality according to local food culture. Higher adherence to traditional diet scores may help prevent disease, yet evidence in adolescents is limited. This cross-sectional study aimed to develop and validate a Traditional Costa Rica Adolescents Diet Score (TCRAD) and determine its association with sociodemographic characteristics, under the hypothesis that girls, adolescents from rural areas, and with low socioeconomic status, have a more traditional healthy diet. A total of 804 urban and rural adolescents (13-18 years old) participated in the study. The TCRAD showed adequate internal validity as shown by significant associations with intake of 14 traditional foods and nutrients (legumes, vegetables, fruits, oils, dairy, and corn tortilla scored as healthy; and white rice, red/processed meat, solid fats, desserts/pastries, sugar-sweetened beverages, snacks, fast food, and bread and cookies scored as unhealthy). A high TCRAD score, indicative of a healthier and more traditional diet, was observed among adolescents in the low socioeconomic group vs. medium or high socioeconomic categories (42.9, 41.2, and 38.2%, respectively, p < 0.05), adolescents living in rural areas vs. urban (47.6 vs. 34.2%, p < 0.05), and among boys vs. girls (46.9 vs. 37.5%, p < 0.05). The TCRAD score is a valid tool to capture diet quality of adolescents in Costa Rica and could be used to measure association of diet with disease outcomes in this and similar populations. Public health nutrition programs in Costa Rica should focus on improving intake of foods and nutrients, and prioritize girls, adolescents in urban areas, and adolescents with high socioeconomic status.